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Exodus: Belize’s nurses seek greener pastures

HeadlineExodus: Belize’s nurses seek greener pastures

BELIZE CITY, Thurs. June 17, 2021– Since last month, reports began to circulate of an imminent shortage of nurses in the country. Those reports were confirmed last week when it became known that 35 Filipino nurses, all on special contracts, would be resigning from the Karl Heusner Memorial Hospital (KHMH).

Their departure will exacerbate what appears to be a pre-existing staffing crisis at the national referral hospital. In an exclusive interview with Amandala this week, Darrell Spencer, president of the Nurses Association of Belize (NAB), told us that the shortage has existed countrywide for a number of years.

“The moving, the traveling, the exodus of nurses, has been [from] time immemorial. The shortage is international, so one would have to say, if there is a short everywhere, then more than likely people would go to the highest bidder, right? For their advancement. That is excruciating, more so on a small country like Belize, and it’s not that we don’t have talent. We have the talent, just that our market is so small that the international market grapple up the nurse as soon as they are available,” Spencer explained.

The World Health Organization (WHO) estimates a global shortage of around 5.9 million nurses. Nurses make up 59% of the global healthcare workforce. WHO has also pointed to a high burnout rate in nurses in underdeveloped countries. These rates have been worsened by the onset of the global COVID-19 pandemic.

In Belize, the dissatisfaction among nurses, and the resulting exodus of these essential healthcare workers, can be traced to two main factors. One of those is a reluctance on the part of the administrations which have governed the country over the past few decades, to increase the number of nursing jobs and key nursing posts which are available within the local healthcare system. The other is the lack of a proper retention package for nurses — one that will encourage them to stay and work in Belize’s healthcare system.

Spencer said that a large number of nurses employed across the system are contract workers, and many fully trained, professional nurses have to wait at times for months before getting a contract placement. This, he explained, has diminished many Belizean nurses’ willingness to contribute to our healthcare system, and has caused them to seek opportunities overseas.

According to Spencer, who has worked as a nurse for almost 30 years, since Belize got its independence in 1981, there has been a marked increase in the country’s population. This has led to an increase in the number of patients being treated (and thus the bed count) at almost all local healthcare facilities, and an increase in services provided.

Despite this, Spencer pointed out, “the amount of jobs available for nurses has stayed the same.” “That doesn’t make any sense. So the nurse is left to fend for him or herself after finishing school; there is not that easy transition that exists,” he said.

Spencer said that nurses have been begging the government to increase the number of posts available for nurses, so that newly trained nurses can more easily obtain a job when they complete their schooling. They have also been asking for a meaningful retention package, with benefits that would encourage them to stay and work in Belize.

“You grow in Belize, you study in Belize, you get trained and qualified in Belize. You didn’t do all of that to go to another country to work. The problem is when you are finish study now, you realize that your country does not respect you enough to make you want to stay, so nurse move on, and I can’t blame them. I am proud of them,” Spencer remarked.

He stated that at this time, there are about 580-600 nurses working in the public health system, and he estimated, based on statistics compiled by WHO and WHO’s recommended ratios, that this number would have to almost be doubled in order for the country to have the number of nurses needed to run our healthcare system optimally.

“I think the last figure was somewhere around, in the public system, 580-600 nurses working throughout the country. If you are going to apply the WHO patient-to-nurse ratio, we should be almost double that in this country, so we are talking about another 500. We’ve gone through all that data and realize, look, our country cannot afford 500 more or 600 more nurses, but the least we can settle with to have a properly running nursing foundation in the hospitals, is somewhere around 200 nurses,” Spencer said.

He shared that over the 30 years during which he has worked within Belize’s healthcare system, he has become acquainted with over 200 nurses who have left the country to seek better opportunities elsewhere.

The Ministry of Health and Wellness, possibly in an effort to address or prevent the scheduled departure of 35 Filipino nurses from the KHMH, has opted to facilitate a waiver of the temporary employment fees that are usually required for Filipino nurses working in our system. They have collaborated with the Ministry of Immigration to put in place the specific terms of a waiver which will remain in effect until February 2022. The waiver was extended to 33 Filipino nurses.

A release from the Health Ministry stated, “Both the Ministries of Health & Wellness and Foreign Affairs, Foreign Trade and Immigration are in discussion to further extend this waiver of fees to accommodate all other foreign health workers who are contracted to work within the healthcare system of Belize.”

Regardless of the outcome which results from the introduction of the waiver, Chairman of the KHMH, Dr. Andre Sosa, told local media that the hospital will be seeking to fill the shortfall with newly trained nurses from the University of Belize. Forty new nurses are set to graduate this year.

We asked Spencer what is the NAB’s view on the government’s intent to secure the services of foreign nurses as a way to remedy the shortfall in the system. He replied that while upping the manpower at the hospital through the hiring of foreign personnel is a quick fix, focusing on honing local talent would be of greater benefit to the country.

Spencer pointed out that due to the working environment in Belize, nurses acquire an array of skills that can be used across units. At times, he noted, this diverse skill set is not present in nurses who come from foreign countries.

He added that a medium to long-term fix would be a proper retention program for nurses, so that those who are products of our system stay in Belize, as well as an increase in the number of nursing posts in order to increase the nurse quota.

He added that there must be an improvement in the overall treatment of nurses, and cited the valiant work done by the country’s nurses during the early months of the pandemic. In light of such valiant work, the recent 10% cut to their salaries is a slap in the face, he further said.

“We are tired, we are frustrated, we feel disrespected. We just delivered the country through the toughest part of the pandemic, and we hope it doesn’t go back to that state in the country, but we just done that. And to come out, you are going to tell me, ‘I thank you very much for your service, here is a 10% cut to your salary.’ We are tired of the way the government operates, we are tired of our treatment by our senior managers in the department, we are tired because there are too many patients for the amount of us working, we are tired because the government has decided that we cannot do overtime to the degree that is necessary to have enough personnel on the ward. We are tired of these things.” Spencer said.

In reference to the 10% salary cut, he remarked, “If you are going to cut the hours to compensate for a salary cut, the sensible thing would have been not to cut the salaries in the first place. You are already short, so you need overtime in excess of the 40 hours a week. You need additional hours to cover the department. How does cutting the hours to 35 now make the overtime any less? You have now put yourself in a position where for those last five hours, for example, if you were paying me $10 an hour for those given hours to make 40, you would now have to start paying me $15 for those same five hours to make 40, so you’ve increased the amount of hours that will be covered by overtime. Don’t you think the sensible thing would have been not to cut salaries in the first place, because if you cut salaries and then you cut hours to compensate you are actually increasing the amount you are going to have to pay. I say, inexplicably stupid. “

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